Finding true north for the Canadian Medical Association Journal.

摘要

This year started off looking like the annus horhbilis of the Canadian Medical Association journal (CMAJ). A string of highly publicised events-the censorship of two news articles by the journal's owner, the firings of the senior editors, the resignation of most of the other editors and the editorial board in solidarity-engulfed and threatened to damage irretrievably the credibility of this almost century-old institution and its owner, the Canadian Medical Association (CMA).But occasionally during high crisis an invitation arises to diagnose the underlying structural causes, and to set new bearings. Here I report an exercise of this kind, in which the CMA appointed an eight-person governance review panel (including myself) to study and make consensus recommendations for the future of the CA/IAJ. Readers can view the panel's report online.But why bother prescribing governance? The top tier of medical journals is so richly blessed that one imagines they nearly run themselves. Few other institutions have suchexceptionally well-educated authors, editors, and readers; a willing queue of wealthy advertisers; and a high social status that leads the care-seeking public to defer, literally with their lives, to the application of the knowledge the journal publishes. So long as these planes of the journal intersect harmoniously, a journal does almost run by itself.